Acute Myeloid Leukemia Secondary to Chronic Lymphocytic Leukemia After Prolonged Chlorambucil Therapy: A Case Report.

IF 1.8 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacogenomics & Personalized Medicine Pub Date : 2023-01-01 DOI:10.2147/PGPM.S407940

Yan Wu, Shan Liu, Dongmei Wang, Xinjie Yao

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Abstract

Background: This study aimed to improve the understanding of acute myeloid leukemia (AML) secondary to chronic lymphocytic leukemia (CLL), and to explore the sequence of occurrence and clonal origin of the two diseases.

Case report: We reported a case of a 71-year-old man with a history of CLL. The patient was administrated with chlorambucil for 19 years and was admitted to our hospital due to fever. Then he was subjected with routine blood tests, bone marrow smear examination, flow cytometric immunophenotyping and cytogenetic analysis. A final diagnosis of AML-M2 secondary to CLL with -Y,del(4q),del(5q),-7,add(12p),der(17),der(18),-22,+mar was made. After rejecting the therapy with Azacitidine combined with B-cell lymphoma-2 (Bcl-2) inhibitor, the patient died of pulmonary infection.

Conclusion: This case highlights the rare occurrence of AML secondary to CLL after prolonged chlorambucil therapy and the poor prognosis of such cases, underscoring the importance of enhanced assessment of these patients.

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长期氯霉素治疗后继发于慢性淋巴细胞白血病的急性髓性白血病一例报告。

背景:本研究旨在提高对继发于慢性淋巴细胞白血病(CLL)的急性髓系白血病(AML)的认识，探讨两种疾病的发生序列和克隆起源。病例报告:我们报告了一例71岁男性CLL病史。患者用药氯苯19年，因发热入院。然后进行血常规、骨髓涂片检查、流式细胞术免疫表型和细胞遗传学分析。最终诊断继发于CLL的AML-M2为-Y、del(4q)、del(5q)、-7、add(12p)、der(17)、der(18)、-22、+mar。在拒绝阿扎胞苷联合b细胞淋巴瘤-2 (Bcl-2)抑制剂治疗后，患者死于肺部感染。结论:本病例突出了氯霉素长期治疗后继发于CLL的AML发生率较低，且预后较差，强调了加强对这类患者评估的重要性。

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来源期刊

Pharmacogenomics & Personalized Medicine Biochemistry, Genetics and Molecular Biology-Molecular Medicine

CiteScore

3.30

自引率

5.30%

发文量

110

审稿时长

16 weeks

期刊介绍： Pharmacogenomics and Personalized Medicine is an international, peer-reviewed, open-access journal characterizing the influence of genotype on pharmacology leading to the development of personalized treatment programs and individualized drug selection for improved safety, efficacy and sustainability. In particular, emphasis will be given to: Genomic and proteomic profiling Genetics and drug metabolism Targeted drug identification and discovery Optimizing drug selection & dosage based on patient''s genetic profile Drug related morbidity & mortality intervention Advanced disease screening and targeted therapeutic intervention Genetic based vaccine development Patient satisfaction and preference Health economic evaluations Practical and organizational issues in the development and implementation of personalized medicine programs.